| NPI | 1831117746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA MOORE Administration 229-225-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 039824) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: GA 043430) |
| 207N00000X Dermatology (Licence: GA 044161) | |
| 207R00000X Internal Medicine (Licence: GA 031427) | |
| 207R00000X Internal Medicine (Licence: GA 044213) | |
| 207R00000X Internal Medicine (Licence: GA 045191) | |
| 207R00000X Internal Medicine (Licence: GA 027373) | |
| 207R00000X Internal Medicine (Licence: GA 027459) | |
| 207R00000X Internal Medicine (Licence: GA 010526) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 034272) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: GA 034186) | |
| 207ZD0900X Pathology, Dermatopathology (Licence: GA 035335) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 056867) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-08-22 |